Higher omega-3 index is associated with more rapid heart rate recovery in healthy men and women

Prostaglandins Leukot Essent Fatty Acids. 2020 Dec;163:102206. doi: 10.1016/j.plefa.2020.102206. Epub 2020 Nov 13.


Background: Previous studies have suggested that omega-3 polyunsaturated fatty acids (n-3 PUFA) can favorably influence cardiac autonomic tone. However, data regarding n-3 PUFA status and heart rate recovery (HRR) in healthy adults are sparse.

Purpose: To examine the association between n-3 PUFA status and HRR.

Methods: Participants included 13,912 patients who underwent a comprehensive examination at the Cooper Clinic, Dallas TX. Fitness was determined from a maximal exercise test. HRR was calculated by subtracting the heart rate at 1, 3, and 5 min of an active recovery period from the maximal heart rate. Participants were categorized as having a low (<4%), normal (4-8%) or optimal (>8%) Omega-3 Index (O3I) (i.e., erythrocyte levels of eicosapentaenoic and docosahexaenoic acids). Multiple linear regression was used to model the association between O3I and HRR adjusting for age, maximal METs, body mass index, and smoking by sex.

Results: Higher categories of O3I were associated with greater HRR at 1 min (men: 23.7, 23.9, 24.6 beats/min; women: 23.9, 24.6, 25.9 and 3 min (men: 52.4, 52.9, 53.6 beats/min; women: 51.9, 53.4, 54.6), p trend <0.01 for all. Corresponding HRR at 5 min were (men: 60.0, 60.2, 60.7 beats/min, p trend=0.09; women: 59.4, 60.8, 61.6, p trend <0.001). The HRR gradients across O3I categories were steeper in women than men at 1, 3, and 5 min (p<0.03 for all sex x O3I category interactions with HRR).

Conclusions: A direct relationship between HRR and O3I values was observed in both men and women, with a steeper gradient in women. These findings suggest a potential cardioprotective mechanism for n-3 PUFA.

Keywords: Docosahexaenoic acid; Eicosapentaenoic acid; Exercise testing; Fish oil; Pulse rate.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Cardiotonic Agents / blood*
  • Exercise Test*
  • Fatty Acids, Omega-3 / blood*
  • Female
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged


  • Cardiotonic Agents
  • Fatty Acids, Omega-3